Scottish Drugs Forum
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DEVELOPMENT of the Scottish Government’s drugs strategy is drawing to a conclusion with an emerging emphasis on recovery.
Scottish Drugs Forum welcomes this approach, especially the clear intention of the Government to set aside the manufactured debate on abstinence versus harm reduction.
What came across strongly at a recent national conference on recovery – and picked up by the conference Chair, Professor Susan Deacon, of Queen Margaret University, Edinburgh – was that it is really simply common sense. However, there is a gap between the principles of working towards recovery and making it a practical reality.
One of the first priorities must be to reach agreement on what actually constitutes “recovery” to dispel considerable fears in some quarters that it is just another name for a 12-step abstinence model. Speaking at this national conference, Simon Bradshaw – Director of the mental health charity Scottish Recovery Network (SRN) – gave a comprehensive outline of a mental health recovery concept and how SRN has developed it to enable people with long term mental health problems.
In an attempt to dispel fears and progress the debate, we have adapted SRN’s working definitions of recovery to read: “For those who have a drug problem, we should be enabling them to live a meaningful and satisfying life, as defined by each person. Each person’s attempt to deal with their drug problem is a unique and deeply personal process.
“It is important to be clear that there are many different paths to wellbeing and recovery, which may or may not include substitute medication. It is important that a full range of accessible, high-quality non-judgemental services are available at the point of need.”
essential
The Scottish Recovery Network also highlighted essential recovery ingredients that will resonate within the drugs field. That the basis of any recovery-orientated practice includes the development of respectful and trusting relationships with service users, in which the worker has a genuine interest in the person, sees them as an individual and takes them and their experiences seriously.
That service users must also have a say in their care, be given more information and where possible, different options for treatment and support and take responsibility for their own choices.
All importantly, that a balance has to be struck between creating safety and letting people take risks as recovery can be helped through challenging service users’ boundaries.
SRN also highlights the lack of a recovery culture (among service users and professionals) to encourage and promote self determination and choice. This, they rightly say, is coupled with a “tartan mindset” of not being comfortable with challenging professionals or being demanding of rights. There is good reason why this submissive approach exists, according to some of the disgraceful anecdotal experiences of users relayed to SDF over recent months, but they are hurdles that we, in the drug field, must overcome.
Meanwhile, the list of obstacles to recovery-orientated practice in mental health is an all-too-familiar list.
Overworked staff, a lack of time and resources and a reality clash between training and existing work practice – such as housing, employability and family support – are among the chief culprits, along with the UK welfare benefits system which focuses too much on what people can’t rather than what they can do, according to SRN.
Importantly, service user input to training courses and services, through structures that support and reward genuine service user involvement, also need to be developed to support recovery-oriented practice.
So make no mistake about this, the challenges ahead to ensure that the fundamental changes required to make such an ambitious goal possible are considerable.
questions
But how can recovery be achieved in a system already beset by chronic and long-standing issues such as waiting times of more than a year?
By inflexible, “factory” treatment which neither suits the services or those using them? Or by short-term project funding?
And when the approach to tackling drug dependency remains dominated either by criminal justice or narrow medical models instead of social care and regeneration?
With nearly eight out of ten drug users seeking help being unemployed, mostly long-term, the ‘regeneration recovery’ landscape for them looks bleak. Many specialist employability projects across Scotland face the axe due to funding cuts, and with no new money available, the latest UK drugs strategy has outlined that many drug users on benefits will have a responsibility to move successfully through treatment and into employment.
What part, therefore, can recovery play in addressing the long-term question posed by the Scottish Future’s Forum, the parliament’s think tank: “How can Scotland reduce the damage to its population through alcohol and drugs by half by the year 2025?”
The forum’s year long work trying to answer the question ends soon, against a difficult local backdrop of the squeeze on public spending and the wider downturn in the global economy. Many young people are still being “pushed out” of the care system before they are ready, fewer pupils from deprived backgrounds are going to university despite a raft of initiatives and the length of time people are homeless, while councils in Scotland find them accommodation, has trebled in recent years.
However, all is not bleak. Glasgow City Council’s recent initiative to offer all school leavers an apprenticeship opportunity next year is the type of initiative which may answer the Futures Forum question about reducing damaging substance use. Such projects require enormous vision, energy and commitment to deliver – but they are exactly what’s needed to ensure that recovery does not become a hollow phrase.